Sally A Peters, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

061437-1 Issued in NY

Practice address

3405 Fontana Lake Dr
Fuquay Varina, NC 27526-0109

Phone

(631) 793-2846

NPI assigned

May 31, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Brightside Medical of New Jersey PCGroup PAC ID 5799141750, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634
  Medicare reassignment Care Compare group NPD
• Brightside Medical of New Jersey, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1811524754

  NC

  Medicare reassignment Care Compare group NPD
• Best Day Psychiatry and Counseling, PC

  • Prescribing (Medical) Psychologist
  • Fayetteville, NC
  • NPI 1477506343

  Clinical

  Medicare reassignment NPD
• Best Day Psychiatry and Counseling, PC

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1891226858
  NPD
• Ableto Behavioral Health Services, PC

  • Clinical Social Worker
  • New York, NY
  • NPI 1235427667
  NPD
• Best Day Psychiatry and Counseling, PC

  • Psychiatry Physician
  • Mt Pleasant, SC
  • NPI 1467291542
  NPD
• Metropolitan Psychological & Licensed Master Social Work Services PLLC

  • Clinical Psychologist
  • Bay Shore, NY
  • NPI 1891833588
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1235131566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 FONTANA LAKE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275260109",
            "telephone_number": "631-793-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 FONTANA LAKE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275260109",
            "telephone_number": "631-793-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "SALLY",
        "middle_name": "A",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "061437-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Connections PLLC
• Tiesha Peebles
• Nadia Perez
• Marcy Alana Person
• Courtney Pestovich, LCMHCA, CRC
• Bridget Ann Peterson, OTRL
• Alicia Ivana Peton, M.S., LCMHC
• Lori Johnson Petree, DDS
• Chante Dominique Pettiford, DPT
• Phoenix Partners NC

• Clinical Social Worker in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.